改良法治疗巨块型腹壁瘢痕子宫内膜异位症14例临床分析

发布时间：2018-06-12 12:56

本文选题：腹壁瘢痕子宫内膜异位症 + 手术　；参考：《现代妇产科进展》2017年06期

【摘要】：目的:探讨改良法治疗剖宫产术后巨块型腹壁瘢痕子宫内膜异位症(EMs)的疗效。方法:回顾分析2010年1月至2015年10月于中山大学附属第一医院妇科行手术治疗并经术后病理证实病灶直径大于5cm的14例剖宫产后腹壁瘢痕EMs患者的临床病例资料,其中6例采用常规手术(切口直径大于病灶1~2cm),8例采用改良手术(切口扩大至原剖宫产瘢痕大小并整形切口)。结果:14例患者病灶均累及脂肪组织、腹直肌及筋膜层,5例同时累及腹膜层。切除病灶直径6~10cm,平均7.5cm。5例行常规手术的患者术后出现切口脂肪液化,切口渗液平均8.9天(7~15天),术后复诊见患者腹壁切口处局部不平整,有不同程度凹陷或隆起。8例行改良手术的患者术后切口渗液平均3.8天(0~7天),腹壁手术瘢痕处切口对合好,腹壁平整,无凹陷或隆起。结论:改良术式治疗腹壁瘢痕内异症,术后伤口渗液少,愈合快,切口整齐美观,疗效确切,值得临床推广。
[Abstract]:Objective: to investigate the effect of modified method on massive abdominal scar endometriosis after cesarean section. Methods: the clinical data of 14 patients with postcesarean scar (EMs) undergoing gynecological surgery in the first affiliated Hospital of Sun Yat-sen University from January 2010 to October 2015 and proved by pathology to be larger than 5cm were retrospectively analyzed. Among them, 6 cases were treated with conventional operation (the diameter of the incision was larger than 1 ~ 2 cm) and 8 cases were treated with modified operation (the incision was expanded to the size of the original cesarean scar and the plastic incision was performed. Results all the lesions of 14 cases involved adipose tissue, and 5 cases of rectus abdominis and fascia were involved in the peritoneal layer at the same time. The diameter of the lesion was 6 ~ 10 cm. The average 7.5cm.5 patients who underwent routine operation had incision fat liquefaction, incision exudate averaged 8.9 days and 715 days. The local incision of the abdominal wall of the patients was found to be unleveled after operation. The average incision exudate was 3.8 days and 7 days after operation in patients with different degree of depression or uplift. The incision at the scar of abdominal wall was well closed, the abdominal wall was flat, and there was no indentation or bulge. Conclusion: the modified operation has the advantages of less exudate, quick healing, neat and beautiful incision, definite curative effect and worthy of clinical application.
【作者单位】：中山大学附属第一医院;
【分类号】：R713.4

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